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http://dx.doi.org/10.4047/jap.2016.8.6.494

The prognosis of splinted restoration of the most-distal implants in the posterior region  

Lee, Jong-Bin (Department of Periodontology, Ewha Womans University Mokdong Hospital)
Kim, Man-Yong (Department of Prosthodontics, Ilsan Hospital, National Health Insurance Service)
Kim, Chang-Sung (Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University)
Kim, Young-Taek (Department of Periodontology, Ilsan Hospital, National Health Insurance Service)
Publication Information
The Journal of Advanced Prosthodontics / v.8, no.6, 2016 , pp. 494-503 More about this Journal
Abstract
PURPOSE. The aim of this study was to compare the efficacies of two-implant splinting (2-IS) and single-implant restoration (1-IR) in the first and second molar regions over a mean functional loading period (FLP) of 40 months, and to propose the appropriate clinical considerations for the splinting technique. MATERIALS AND METHODS. The following clinical factors were examined in the 1-IR and 2-IS groups based on the total hospital records of the patients: sex, mean age, implant location, FLP, bone grafting, clinical crown-implant ratio, crown height space, and horizontal distance. The mechanical complications [i.e., screw loosening (SL), screw fracture, crown fracture, and repeated SL] and biological complications [i.e., peri-implant mucositis (PM) and peri-implantitis (PI)] were also evaluated for each patient. In analysis of two groups, the chi-square test and Student's t-test were used to identify the relationship between clinical factors and complication rates. The optimal cutoff value for the FLP based on complications was evaluated using receiver operating characteristics analysis. RESULTS. In total, 234 patients with 408 implants that had been placed during 2005 - 2014 were investigated. The incident rates of SL (P<.001), PM (P=.002), and PI (P=.046) differed significantly between the 1-IR and 2-IS groups. The FLP was the only meaningful clinical factor for mechanical and biological complication rates in 2-IS. CONCLUSION. The mechanical complication rates were lower for 2-IS than for 1-IR, while the biological complication rates were higher for 2-IS. FLP of 39.80 and 46.57 months were the reference follow-up periods for preventing biological and mechanical complications, respectively.
Keywords
Implant restoration; Splinted restoration; Posterior region; Complication rates; Functional loading period;
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1 Yuan JC, Sukotjo C. Occlusion for implant-supported fixed dental prostheses in partially edentulous patients: a literature review and current concepts. J Periodontal Implant Sci 2013;43:51-7.   DOI
2 Johansson A, Omar R, Carlsson GE. Bruxism and prosthetic treatment: a critical review. J Prosthodont Res 2011;55:127-36.   DOI
3 Falcon-Antenucci RM, Pellizzer EP, de Carvalho PS, Goiato MC, Noritomi PY. Influence of cusp inclination on stress distribution in implant-supported prostheses. A three-dimensional finite element analysis. J Prosthodont 2010;19:381-6.   DOI
4 Naert I, Quirynen M, van Steenberghe D, Darius P. A six-year prosthodontic study of 509 consecutively inserted implants for the treatment of partial edentulism. J Prosthet Dent 1992;67:236-45.   DOI
5 van Steenberghe D, Lekholm U, Bolender C, Folmer T, Henry P, Herrmann I, Higuchi K, Laney W, Linden U, Astrand P. Applicability of osseointegrated oral implants in the rehabilitation of partial edentulism: a prospective multicenter study on 558 fixtures. Int J Oral Maxillofac Implants 1990;5:272-81.
6 Grossmann Y, Finger IM, Block MS. Indications for splinting implant restorations. J Oral Maxillofac Surg 2005;63:1642-52.   DOI
7 Huang HL, Huang JS, Ko CC, Hsu JT, Chang CH, Chen MY. Effects of splinted prosthesis supported a wide implant or two implants: a three-dimensional finite element analysis. Clin Oral Implants Res 2005;16:466-72.   DOI
8 Brunski JB. In vivo bone response to biomechanical loading at the bone/dental-implant interface. Adv Dent Res 1999;13:99-119.   DOI
9 Ishigaki S, Nakano T, Yamada S, Nakamura T, Takashima F. Biomechanical stress in bone surrounding an implant under simulated chewing. Clin Oral Implants Res 2003;14:97-102.   DOI
10 Rangert B, Krogh PH, Langer B, Van Roekel N. Bending overload and implant fracture: a retrospective clinical analysis. Int J Oral Maxillofac Implants 1995;10:326-34. Erratum in: Int J Oral Maxillofac Implants 1996;11:575.
11 Leung KC, Chow TW, Wat PY, Comfort MB. Peri-implant bone loss: management of a patient. Int J Oral Maxillofac Implants 2001;16:273-7.
12 Miyata T, Kobayashi Y, Araki H, Ohto T, Shin K. The influence of controlled occlusal overload on peri-implant tissue. Part 3: A histologic study in monkeys. Int J Oral Maxillofac Implants 2000;15:425-31.
13 Faucher RR, Bryant RA. Bilateral fixed splints. Int J Periodontics Restorative Dent 1983;3:8-37.
14 Isidor F. Influence of forces on peri-implant bone. Clin Oral Implants Res 2006;17:8-18.
15 Weinberg LA. Reduction of implant loading using a modified centric occlusal anatomy. Int J Prosthodont 1998;11:55-69.
16 Skalak R. Biomechanical considerations in osseointegrated prostheses. J Prosthet Dent 1983;49:843-8.   DOI
17 Barbier L, Schepers E. Adaptive bone remodeling around oral implants under axial and nonaxial loading conditions in the dog mandible. Int J Oral Maxillofac Implants 1997;12: 215-23.
18 Brunski JB, Puleo DA, Nanci A. Biomaterials and biomechanics of oral and maxillofacial implants: current status and future developments. Int J Oral Maxillofac Implants 2000;15:15-46.
19 Guichet DL, Yoshinobu D, Caputo AA. Effect of splinting and interproximal contact tightness on load transfer by implant restorations. J Prosthet Dent 2002;87:528-35.   DOI
20 Misch CE, Goodacre CJ, Finley JM, Misch CM, Marinbach M, Dabrowsky T, English CE, Kois JC, Cronin RJ Jr. Consensus conference panel report: crown-height space guidelines for implant dentistry-part 1. Implant Dent 2005;14:312-8.   DOI
21 Herbst D, Nel JC, Driessen CH, Becker PJ. Evaluation of impression accuracy for osseointegrated implant supported superstructures. J Prosthet Dent 2000;83:555-61.   DOI
22 Tarnow DP, Cho SC, Wallace SS. The effect of inter-implant distance on the height of inter-implant bone crest. J Periodontol 2000;71:546-9.   DOI
23 Naert I, Koutsikakis G, Duyck J, Quirynen M, Jacobs R, van Steenberghe D. Biologic outcome of implant-supported restorations in the treatment of partial edentulism. part I: a longitudinal clinical evaluation. Clin Oral Implants Res 2002;13:381-9.   DOI
24 Stegaroiu R, Sato T, Kusakari H, Miyakawa O. Influence of restoration type on stress distribution in bone around implants: a three-dimensional finite element analysis. Int J Oral Maxillofac Implants 1998;13:82-90.
25 Landry KE, Johnson PF, Parks VJ, Pelleu GB Jr. A photoelastic study to determine the location of the nonrigid connector in a five-unit intermediate abutment prosthesis. J Prosthet Dent 1987;57:454-7.   DOI
26 Nissan J, Gross O, Ghelfan O, Priel I, Gross M, Chaushu G. The effect of splinting implant-supported restorations on stress distribution of different crown-implant ratios and crown height spaces. J Oral Maxillofac Surg 2011;69:2990-4.   DOI
27 Klinge B, Meyle J, Working Group. Peri-implant tissue destruction. The Third EAO Consensus Conference 2012. Clin Oral Implants Res 2012;23:108-10.   DOI
28 Rangert BR, Sullivan RM, Jemt TM. Load factor control for implants in the posterior partially edentulous segment. Int J Oral Maxillofac Implants 1997;12:360-70.
29 Nissan J, Ghelfan O, Gross O, Priel I, Gross M, Chaushu G. The effect of crown/implant ratio and crown height space on stress distribution in unsplinted implant supporting restorations. J Oral Maxillofac Surg 2011;69:1934-9.   DOI
30 Morneburg TR, Proschel PA. In vivo forces on implants influenced by occlusal scheme and food consistency. Int J Prosthodont 2003;16:481-6.
31 Lee JH, Lee JB, Park JI, Choi SH, Kim YT. Mechanical complication rates and optimal horizontal distance of the most distally positioned implant-supported single crowns in the posterior region: A study with a mean follow-up of 3 years. J Prosthodont 2015 Jun 19.
32 Nothdurft FP, Nonhoff J, Pospiech PR. Pre-fabricated zirconium dioxide implant abutments for single-tooth replacement in the posterior region: success and failure after 3 years of function. Acta Odontol Scand 2014;72:392-400.   DOI
33 Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res 2012;23:2-21.   DOI
34 Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res 2008;19:119-30.   DOI
35 Simon RL. Single implant-supported molar and premolar crowns: a ten-year retrospective clinical report. J Prosthet Dent 2003;90:517-21.   DOI
36 Weber HP, Sukotjo C. Does the type of implant prosthesis affect outcomes in the partially edentulous patient? Int J Oral Maxillofac Implants 2007;22:140-72.
37 Theoharidou A, Petridis HP, Tzannas K, Garefis P. Abutment screw loosening in single-implant restorations: a systematic review. Int J Oral Maxillofac Implants 2008;23:681-90.
38 Miyaura K, Matsuka Y, Morita M, Yamashita A, Watanabe T. Comparison of biting forces in different age and sex groups: a study of biting efficiency with mobile and non-mobile teeth. J Oral Rehabil 1999;26:223-7.   DOI
39 Ferrario VF, Sforza C, Serrao G, Dellavia C, Tartaglia GM. Single tooth bite forces in healthy young adults. J Oral Rehabil 2004;31:18-22.   DOI
40 Sepetcioglu F, Ataman BA. Long-term monitoring of microleakage of cavity varnish and adhesive resin with amalgam. J Prosthet Dent 1998;79:136-9.   DOI
41 Bidra AS. Nonsurgical management of inflammatory periimplant disease caused by food impaction: a clinical report. J Prosthet Dent 2014;111:96-100.   DOI
42 Kim YK, Kim SG, Yun PY, Hwang JW, Son MK. Prognosis of single molar implants: a retrospective study. Int J Periodontics Restorative Dent 2010;30:401-7.
43 Levin L, Laviv A, Schwartz-Arad D. Long-term success of implants replacing a single molar. J Periodontol 2006;77:1528-32.   DOI
44 Biancu S, Ericsson I, Lindhe J. Periodontal ligament tissue reactions to trauma and gingival inflammation. An experimental study in the beagle dog. J Clin Periodontol 1995;22:772-9.   DOI
45 Abrahamsson I, Berglundh T, Lindhe J. The mucosal barrier following abutment dis/reconnection. An experimental study in dogs. J Clin Periodontol 1997;24:568-72.   DOI
46 Simonis P, Dufour T, Tenenbaum H. Long-term implant survival and success: a 10-16-year follow-up of non-submerged dental implants. Clin Oral Implants Res 2010;21:772-7.   DOI
47 Linkevicius T, Vladimirovas E, Grybauskas S, Puisys A, Rutkunas V. Veneer fracture in implant-supported metal-ceramic restorations. Part I: Overall success rate and impact of occlusal guidance. Stomatologija 2008;10:133-9.
48 Pjetursson BE, Tan K, Lang NP, Bragger U, Egger M, Zwahlen M. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res 2004;15:667-76.   DOI